Comparative evaluation of genotoxicity and cytotoxicity of flowable, bulk-fill flowable, and nanohybrid composites in human gingival cells using cytome assay: An in vivo study

CONTEXT: Biocompatibility is one of the major prerequisites for safe clinical application of materials. Resin composites release their components into oral environment following restoration which cause adverse reactions. AIMS: To evaluate and compare the genotoxicity and cytotoxicity of flowable, bulk-fill flowable, and nanohybrid composites with glass ionomer cement in human gingival cells using epithelial-based cytome assay. METHODOLOGY: Sixty healthy patients with noncarious cervical lesions were selected and randomly assigned to four groups (n = 15): Group A, glass ionomer cement; Group B, flowable composite; Group C, bulk-fill flowable composite; and Group D, nanohybrid composite. Class V restorations were done in each group with the respective restorative materials. Samples of epithelial cells were collected from gingiva before (control) (T1) and after 10 and 30 days (T2 and T3) postrestoration and examined for the presence of micronuclei and other nuclear anomalies. STATISTICAL ANALYSIS USED: The results were subjected to statistical analysis using Friedman's test and Kruskal–Wallis test. RESULTS: The highest level of cytotoxicity was noted at T2 time point with a significant decline at T3 time point. Least cytotoxic damage was exhibited by Group A followed by Group D. Highest cytotoxic effect was shown by Group B followed by Group C. There was no significant level of genotoxicity induced by any of the materials tested at different time points. CONCLUSION: There is significant cytotoxicity induced by the tested composite materials which had no long-term effects and no genotoxicity was induced by any of the restorative materials tested.